Elanguest is now proudly partnered with EC English Language Centres, Malta.

A Universal Standard in Medical English

The purpose of sTANDEM is to create a language examination to be used as a standard of measurement for medical English competency throughout Europe, and perhaps eventually elsewhere.

A Fatal Error

In 2008, English patient David Gray was prescribed 10 times the normal dose of his medication, resulting in his death. His doctor, a non-native English speaker, testified that the mistake was the result of confusion over differences between drugs used in Germany and those used in the UK.

This highly publicised case is just one of many situations, whose unknown numbers may rank in the thousands, of lethal or otherwise dangerous mistakes due to lack of good English communication in the medical field.

Even those errors which do not result in death can cause serious discomfort to patients, who in many cases are already in a weakened state and are unable to advocate for themselves.


Work Mobility – A Benefit and a DangerIn Great Britain, nearly one third of medical doctors are non-native English speakers, and approximately one fourth of that number are from the EU. These foreign professionals are an integral part of the National Health Service’s functionality, but their lack of communication skills in the English particular to the medical field is causing serious problems. The UK’s General Medical Council and Nursing and Midwifery Council have raised concerns to the European Union, calling for urgent action to combat this problem.The problem is not confined to the United Kingdom. The increase of work mobility throughout Europe has necessitated the use of an international language for communication among medical personnel, and in turn their communication with patients.Standard testing and competency systems, notably the Cambridge CELA (formerly ESOL) examinations and the Common European Framework of Reference for Languages, already exist and are used and trusted throughout the EFL world, however, these exams have not proved to be sufficient to test competency in medical English. Even those healthcare professionals who must undergo rigourous English exams before entering employment in their fields may not know the vocabulary and usage particular to the world of medicine, which is particularly important as lives and human suffering can be greatly affected by it.

A Solution

The sTANDEM team
Enter: sTANDEM—Standardised Language Examinations for Medical Purposes. This project of the EU Lifelong Learning Programme was begun in 2011 and is scheduled to be finished in 2014. The purpose of sTANDEM is to create a language examination to be used as a standard of measurement for medical English competency throughout Europe, and perhaps eventually elsewhere. In the future, the project will extend to include lingua franca tests for medical workers in specific countries. So far these plans include German, French, Polish, Hungarian, and Romanian.The European Association of Science Editors, one of the project’s core partners, describes it as follows:“This system is intended to promote, assess, and certify the command of professional English among health care professionals world-wide. It will enable hospitals, and other health institutions where English is the language of communication, who plan to employ staff, research fellows, or externs whose first language is not English, to obtain sound information about their English language proficiency in a professional context. EASE endorses both standardisation of scientific (including medical) terminology and the use of clear language by all authors of scientific publications in English.”The finished project is planned to include tests for lower intermediate to upper intermediate levels, known as B1 – C1 in the Common European Framework, and equivalent to the FCE – CAE levels of the Cambridge CELA examinations.The Project Consortium

The project consortium is made up of 10 Core Partner Institutions, 14 Supporting Partners, and 8 Associated Partners.

The team with members of Elanguest staff and the Maltese press
Core Partners are Jagiellonian University Medical College from Poland; Innsbruck Medical University from Austria; Dijon School of Medicine from France; University of Pecs, Faculty of General Medicine from Hungary; University of Medicine and Pharmacy of Targu Mures in Romania; University of Edinburgh from the UK; Tokyo Medical University, Department of International Medical Communications in Japan; The European Association of Science Editors from the UK; The European Association for Communication in Healthcare from the Netherlands; and Elanguest English Language School from Malta.

Supporting Partners include prestigious medical institutions from around the world, including the Centers for Disease Control, Johns Hopkins School of Medicine, the National Institutes of Health, the New England Journal of Medicine, and the Mayo Clinic from the United States; Primal Pictures and Myeloma from the UK; Emergency Medicine Cases from Canada; Virtual Medical Centre from Australia; and the international World Health Organisation. The role of these supporting partners is to provide access to otherwise copyrighted authentic medical texts and audio recordings from their publications. Obviously, the texts will not be compromised, as examination materials will not be made public.

Associated Partners will be responsible for promoting the project and in some cases acting as examination centres for participants. These partners include Goupe d’Étude et de Recherche en Anglais de Spécialité from France; International Medical Publishing from the Czech Republic; Ioannina Medical School in Greece; MedPharmCareers and MedPharmJobs.com from Poland; The Pyramid Group from Germany; and from outside of Europe, Beijing Uniacare Consulting, and Virtual Medical Centre in Australia.

TheSynapse, a medical professional network, has just recently joined the consortium as both a supporting and associated partner.

Elanguest’s Involvement

Ursula West addressing sTANDEM's core partners

Elanguest is the only non-university educational entity in the group of core partners. A private English language school established in 1991 by the West family in St. Julian’s, Malta, it does however have a rich heritage in the field of medical English. Elanguest created a previous EU Lifelong Learning Programme project, EnglishMed, an online self-study programme for medical English, and later promoted it with the partnership of some of Europe’s top medical universities. The English school regularly holds courses in Medical English, and has recently added 3 specialised courses: English for Doctors, English for Nurses, and English for Pharmacists.

Elanguest was first invited to participate in sTANDEM by Iwona Misztal and Annamaria Gyrfi, now representatives of two of sTANDEM’s core partners. They had come to know the school when they attended Elanguest through an EU mobility programme designed for teachers to share knowledge and expertise.

The project’s non-commercial partners have expressed the value of having a private educational establishment as part of the sTANDEM consortium, as it has introduced more market related aspects to a group of highly academic thinkers.

Phases of the Project

The development of the sTANDEM project consists of several stages. The first of these, the Research phase, has already been completed. This step consisted of a language needs analysis, first by means of a review of existing research, and then by development and distribution of language needs questionnaires within target groups. These groups consisted of 30 students and 30 health care professionals from each of five different non-English-speaking countries. Face-to-face, phone, and email interviews were conducted and language profiles consequently developed according to the needs assessed.

The Development phase is still in progress. Based on the research and needs analysis, an exhaustive collection of specific test sets for each level is being created.

The Validation phase has already begun. The exam papers must be tested for usefulness and linguistic correctness in actual authentic situations. The results of pre-testing within trial groups will be analysed and appropriate modifications made in the materials. A second set of pre-testing will then take place. The project will be submitted for external validation by statistical analysis. Continued quality control will eventually be placed in the hands of an international association to ensure a high standard in the continued application and development of the project.

The Dissemination phase will include training examiners, developing exam centres, organising exams, and promoting the project and its outcomes.

A Symbolic Meeting

During the 5 – 7 of September 2013, 9 representatives from the project’s core consortium, including 6 of the universities and Elanguest English Language School, met for the penultimate meeting in St. Julian’s, on the Mediterranean island of Malta. The final stages of the project were discussed and planned.

The sTANDEM team enjoying a much-needed break and some Maltese hospitality in Spinola Bay
Dr. Gábor Rébék-Nagy from the faculty of General Medicine of the University of Pecs, Hungary observed the significance of the meeting’s location. Malta was ruled for nearly 3 centuries by the Order of the Knights of St. John, also known as the Knights Hospitaller because of their work among the sick. Valletta became home to one of the finest hospitals in Europe, as well as schools of anatomy, surgery, and pharmacy. Though the Knights came from all over Europe, they communicated in common languages for the common purpose of their mission. The sTANDEM project is continuing this legacy in a modern world where much has changed, but where the universal human needs of language and medicine are still very much the same.

By Stephanie Spicer